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Michigan rates for HCPCS 99242

Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.33 / $60.38 / $80.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.90 / $71.15 / $130.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.36 / $78.36 / $78.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.17 / $82.17 / $82.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.06 / $86.28 / $110.93
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.97 / $66.42 / $77.95
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.11 / $90.16 / $140.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.70 / $86.46 / $146.35
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.33 / $87.76 / $101.14
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.33 / $80.42 / $119.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.71 / $71.56 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.68 / $99.62 / $123.93